| NPI | 1366888026 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: GA DN014526) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA 22245) |
| Enumeration Date | 2013-05-21 |
| Last Update Date | 2013-05-21 |