| NPI | 1194947739 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN013402) |
| Additional Taxonomies | 122300000X Dentist (Licence: GA DN03402) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2014-04-28 |