| NPI | 1043619299 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: GA DN015092) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS040071) |
| Enumeration Date | 2014-08-13 |
| Last Update Date | 2021-10-10 |