| NPI | 1578827531 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: GA DN014461) |
| Additional Taxonomies | 122300000X Dentist (Licence: TN DS0000010001) |
| 1223G0001X Dentist, General Practice (Licence: GA DN014461) | |
| 1223G0001X Dentist, General Practice (Licence: TN DS0000010001) | |
| Enumeration Date | 2012-06-25 |
| Last Update Date | 2015-05-05 |