| NPI | 1043575038 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 28095) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WA DE60840887) |
| 122300000X Dentist (Licence: WA DE60840887) | |
| Enumeration Date | 2012-07-06 |
| Last Update Date | 2025-03-27 |