| NPI | 1184950560 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN016097) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 25215) |
| 1223G0001X Dentist, General Practice (Licence: CA 58376) | |
| Enumeration Date | 2009-10-20 |
| Last Update Date | 2020-08-03 |