| NPI | 1821207077 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN123034) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL DN22274) |
| 1223G0001X Dentist, General Practice (Licence: FL DN2274) | |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2023-08-09 |