| NPI | 1992405815 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA dn1860019) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 40301) |
| Enumeration Date | 2023-03-08 |
| Last Update Date | 2025-11-03 |