| NPI | 1386870210 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: GA DN013892) |
| Additional Taxonomies | 122300000X Dentist (Licence: AL 6174C1) |
| Enumeration Date | 2009-06-05 |
| Last Update Date | 2015-05-13 |