| NPI | 1659724532 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN015366) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL DN 22133) |
| Enumeration Date | 2016-07-15 |
| Last Update Date | 2017-05-17 |