| NPI | 1972581981 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0008X Dentist, Oral and Maxillofacial Radiology (Licence: GA DN013165) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 25040) |
| 122300000X Dentist (Licence: SC 4172) | |
| Enumeration Date | 2006-01-09 |
| Last Update Date | 2023-04-13 |