| NPI | 1699826966 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN014697) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: KY 7756) |
| Enumeration Date | 2007-01-15 |
| Last Update Date | 2019-01-25 |