| NPI | 1003346727 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA 61109545) |
| Additional Taxonomies | 122300000X Dentist (Licence: AK 123308) |
| Enumeration Date | 2017-06-14 |
| Last Update Date | 2022-09-21 |