| NPI | 1053578369 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: GA DN013623) |
| Additional Taxonomies | 122300000X Dentist (Licence: AL 5404) |
| 122300000X Dentist (Licence: GA DN013623) | |
| Enumeration Date | 2008-05-22 |
| Last Update Date | 2021-07-26 |