| NPI | 1598070716 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: GA DN015104) |
| Additional Taxonomies | 122300000X Dentist (Licence: MD 14488) |
| 122300000X Dentist (Licence: CT 010331) | |
| Enumeration Date | 2010-08-11 |
| Last Update Date | 2023-03-01 |