| NPI | 1356558837 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: GA DN123052) |
| Additional Taxonomies | 122300000X Dentist (Licence: DC DEN1000244) |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2023-11-01 |