| NPI | 1447454236 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: GA DN013995) |
| Additional Taxonomies | 122300000X Dentist (Licence: NC 8254) |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2025-11-13 |