| NPI | 1659444073 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: GA DN013016) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: GA DN013016) |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2016-05-23 |