| NPI | 1831831973 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: GA DN123043) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN27776) |
| Enumeration Date | 2022-04-09 |
| Last Update Date | 2023-08-15 |