| NPI | 1215099932 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AL 4888) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: GA DN011728) |
| Enumeration Date | 2006-12-16 |
| Last Update Date | 2017-03-29 |