| NPI | 1447460373 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN014554) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DSO35761) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2014-04-21 |