| NPI | 1982392445 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: FL 27960) |
| Additional Taxonomies | 1041S0200X Social Worker, School (Licence: CA 39020000X) |
| Enumeration Date | 2023-04-24 |
| Last Update Date | 2023-07-11 |