| NPI | 1003275546 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: AZ D010180) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: WA DE60751447) |
| Enumeration Date | 2016-02-11 |
| Last Update Date | 2022-07-21 |