| NPI | 1992144554 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN015283) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 057730) |
| Enumeration Date | 2013-06-17 |
| Last Update Date | 2022-07-21 |