| NPI | 1508903048 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN014239) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA 21658) |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2018-01-08 |