| NPI | 1831583905 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: GA DN015602) |
| Additional Taxonomies | 122300000X Dentist (Licence: NC 10281) |
| Enumeration Date | 2015-03-26 |
| Last Update Date | 2020-11-10 |