| NPI | 1417193897 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA 014709) |
| Additional Taxonomies | 122300000X Dentist (Licence: GA dn614709) |
| 1223G0001X Dentist, General Practice (Licence: NY 054076) | |
| Enumeration Date | 2009-01-06 |
| Last Update Date | 2021-10-28 |