| NPI | 1447454236 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN013995) |
| Additional Taxonomies | 122300000X Dentist (Licence: NC 8254) |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2012-03-15 |