| NPI | 1275795353 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA 14901) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 054582) |
| 1223G0001X Dentist, General Practice (Licence: GA dn014901) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2018-03-28 |