| NPI | 1306192232 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: GA DN015787) |
| Additional Taxonomies | 122300000X Dentist (Licence: AR 3893) |
| 122300000X Dentist (Licence: TX 27711) | |
| 1223G0001X Dentist, General Practice (Licence: GA DN015787) | |
| Enumeration Date | 2012-07-30 |
| Last Update Date | 2022-10-07 |