| NPI | 1467528562 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN010948) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: GA DN010948) |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2022-12-21 |