| NPI | 1588395131 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN122858) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DN1859533) |
| Enumeration Date | 2022-06-23 |
| Last Update Date | 2023-01-20 |