| NPI | 1336451467 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: GA DN122410) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 25563) |
| Enumeration Date | 2010-07-06 |
| Last Update Date | 2023-08-23 |