| NPI | 1013148303 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: GA DN014356) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NJ 22DI02394000) |
| Enumeration Date | 2009-08-04 |
| Last Update Date | 2012-04-05 |