| NPI | 1548415771 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: GA DN015339) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019-019945) |
| Enumeration Date | 2008-12-02 |
| Last Update Date | 2017-02-28 |