| NPI | 1144491119 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: GA DN013632) |
| Additional Taxonomies | 122300000X Dentist (Licence: TN 8075) |
| Enumeration Date | 2008-03-18 |
| Last Update Date | 2023-06-23 |