| NPI | 1184836744 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: GA DN014519) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 23126) |
| 1223G0001X Dentist, General Practice (Licence: TN 9061) | |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2014-11-19 |