| NPI | 1801110796 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AL 5654) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: AL 5654) |
| Enumeration Date | 2010-03-21 |
| Last Update Date | 2016-08-26 |