| NPI | 1326472648 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: GA DN015757) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: GA DN015757) |
| 1223G0001X Dentist, General Practice (Licence: FL DN20267) | |
| Enumeration Date | 2013-08-22 |
| Last Update Date | 2019-03-11 |