| NPI | 1750603007 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN015086) |
| Additional Taxonomies | 122300000X Dentist (Licence: AR 3752) |
| 1223G0001X Dentist, General Practice (Licence: NY 057112) | |
| 1223G0001X Dentist, General Practice (Licence: TN DS9102) | |
| Enumeration Date | 2010-02-26 |
| Last Update Date | 2019-07-02 |