| NPI | 1285320507 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: GA DN016088) |
| Additional Taxonomies | 122300000X Dentist (Licence: GA DN016088) |
| Enumeration Date | 2023-04-11 |
| Last Update Date | 2023-08-04 |