| NPI | 1023334331 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OR D9800) |
| Additional Taxonomies | 122300000X Dentist (Licence: WA DE60264832) |
| Enumeration Date | 2010-04-12 |
| Last Update Date | 2014-06-05 |