| NPI | 1669902292 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: GA DN15411) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: GA DN015411) |
| Enumeration Date | 2017-06-15 |
| Last Update Date | 2023-02-19 |