| NPI | 1598801268 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: AR 3557) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: GA 012050) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2020-12-18 |