| NPI | 1295082303 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: GA DN016151) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TN 9487) |
| Enumeration Date | 2012-08-08 |
| Last Update Date | 2021-03-02 |