| NPI | 1073531968 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 4669) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: GA 011979) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2020-03-11 |