| NPI | 1760577316 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: GA 012404) |
| Additional Taxonomies | 122300000X Dentist (Licence: GA DE60521366) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2016-03-22 |