| NPI | 1033235270 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WA DE60451320) |
| Additional Taxonomies | 1223X2210X Dentist, Orofacial Pain (Licence: WA DE60451320) |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2020-05-20 |