| NPI | 1992319271 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: GA DN016131) |
| Additional Taxonomies | 122300000X Dentist (Licence: GA DN016131-T) |
| Enumeration Date | 2020-09-03 |
| Last Update Date | 2021-08-14 |