| NPI | 1336698596 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: GA DNO15297) |
| Additional Taxonomies | 122300000X Dentist (Licence: GA DN015297) |
| Enumeration Date | 2016-09-29 |
| Last Update Date | 2022-10-25 |