| NPI | 1528334257 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN015007) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NC 9295) |
| 1223G0001X Dentist, General Practice (Licence: FL DN 20275) | |
| Enumeration Date | 2012-03-27 |
| Last Update Date | 2016-03-07 |