| NPI | 1477907707 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN123308) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 059199) |
| Enumeration Date | 2016-04-22 |
| Last Update Date | 2026-01-23 |