| NPI | 1992130280 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: GA DN014677) |
| Additional Taxonomies | 122300000X Dentist (Licence: AL 6050 C1) |
| Enumeration Date | 2013-09-05 |
| Last Update Date | 2014-12-09 |