| NPI | 1316570906 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: GA DN122266) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: GA STUDENT) |
| Enumeration Date | 2020-02-21 |
| Last Update Date | 2024-02-13 |