| NPI | 1457377012 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: AR 3311) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: AR 3435) |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2013-04-25 |