| NPI | 1922022615 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: GA GA9901) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: GA DN009901) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2022-07-01 |