| NPI | 1043953151 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: GA DN123200) |
| Additional Taxonomies | 122300000X Dentist (Licence: MO 2022024407) |
| Enumeration Date | 2022-04-16 |
| Last Update Date | 2023-07-28 |