| NPI | 1255567244 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN014380) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS037508) |
| Enumeration Date | 2009-06-03 |
| Last Update Date | 2012-09-20 |