| NPI | 1922528157 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: GA DN122227) |
| Additional Taxonomies | 122300000X Dentist (Licence: WI 1001627-15) |
| Enumeration Date | 2017-06-20 |
| Last Update Date | 2023-11-17 |