| NPI | 1891342119 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: GA DN123659) |
| Additional Taxonomies | 1223D0001X Dentist, Dental Public Health (Licence: NC 11549) |
| 1223G0001X Dentist, General Practice (Licence: NC 11549) | |
| 1223G0001X Dentist, General Practice (Licence: SC 10246) | |
| Enumeration Date | 2019-08-21 |
| Last Update Date | 2025-03-17 |