| NPI | 1306075999 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: GA DN014188) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: SC DGD: 4630) |
| Enumeration Date | 2009-07-06 |
| Last Update Date | 2012-07-27 |