| NPI | 1861837460 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: GA DNF000433) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 20322) |
| Enumeration Date | 2013-05-08 |
| Last Update Date | 2021-10-22 |