| NPI | 1023496312 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WA DE60636741) |
| Additional Taxonomies | 1223D0001X Dentist, Dental Public Health (Licence: WA DE60636741) |
| Enumeration Date | 2015-05-07 |
| Last Update Date | 2021-12-27 |