| NPI | 1831755156 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN123015) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: UT 11262202-9921) |
| Enumeration Date | 2019-05-13 |
| Last Update Date | 2024-03-13 |