| NPI | 1649387127 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: GA DN010318)  | 
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: GA DN010318)  | 
| Enumeration Date | 2006-08-23 | 
| Last Update Date | 2018-04-19 |