| NPI | 1225527914 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: GA DN122573) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: MA DN1857897) |
| Enumeration Date | 2018-05-08 |
| Last Update Date | 2022-02-03 |