| NPI | 1376856971 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN016017) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CT 10318) |
| Enumeration Date | 2010-07-23 |
| Last Update Date | 2021-09-10 |