| NPI | 1023311065 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TN 0000012156) |
| Additional Taxonomies | 122300000X Dentist (Licence: WA DE60019134) |
| Enumeration Date | 2010-12-14 |
| Last Update Date | 2023-06-05 |