| NPI | 1932508496 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: WI 1001171-15) |
| Additional Taxonomies | 122300000X Dentist (Licence: GA DN014857) |
| Enumeration Date | 2014-08-20 |
| Last Update Date | 2023-06-22 |