| NPI | 1639480882 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: GA DN014104) |
| Additional Taxonomies | 1223P0700X Dentist Prosthodontics (Licence: GA DN014104) |
| Enumeration Date | 2010-06-23 |
| Last Update Date | 2023-12-08 |