| NPI | 1487180675 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: GA DN016003) |
| Additional Taxonomies | 122300000X Dentist (Licence: WI 1001409-15) |
| 122300000X Dentist (Licence: GA DN0160003) | |
| Enumeration Date | 2017-05-07 |
| Last Update Date | 2020-08-07 |