| NPI | 1376658278 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: GA DN 11641) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN 8809) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2023-03-07 |