| NPI | 1154633717 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: GA DN014366) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: GA DN014366) |
| 1223G0001X Dentist, General Practice (Licence: VA 0401412888) | |
| Enumeration Date | 2010-07-11 |
| Last Update Date | 2022-07-21 |