| NPI | 1518284660 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: GA DN014024) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS037986) |
| Enumeration Date | 2010-04-29 |
| Last Update Date | 2013-12-11 |