| NPI | 1417692476 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: GA DN122317) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: GA DN122317) |
| 122300000X Dentist (Licence: NC 14550) | |
| Enumeration Date | 2022-05-03 |
| Last Update Date | 2026-01-12 |