| NPI | 1043833395 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE61276613) |
| Additional Taxonomies | 122300000X Dentist (Licence: WA DE61276613) |
| 1223G0001X Dentist, General Practice (Licence: VA 0401417009) | |
| 1223G0001X Dentist, General Practice (Licence: DC DEN1002134) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-05-21 |
| Last Update Date | 2024-10-30 |