| NPI | 1669995593 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: GA DNF000428) |
| Additional Taxonomies | 125Q00000X Oral Medicinist (Licence: GA DNF000428) |
| Enumeration Date | 2017-07-23 |
| Last Update Date | 2023-04-13 |