| NPI | 1518986942 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN008444) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 11586) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2018-03-17 |