| NPI | 1578750279 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN014631) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 051206-1) |
| 1223G0001X Dentist, General Practice (Licence: OH 30.023661) | |
| Enumeration Date | 2007-09-27 |
| Last Update Date | 2013-08-01 |