| NPI | 1164484390 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN015925) |
| Additional Taxonomies | 122300000X Dentist (Licence: VA 0401410261) |
| Enumeration Date | 2006-04-04 |
| Last Update Date | 2024-01-04 |