| NPI | 1073898771 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: GA DN014350) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: GA DN014350) |
| Enumeration Date | 2011-10-14 |
| Last Update Date | 2019-09-10 |