| NPI | 1043883044 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 108338) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WA DE61186121) |
| Enumeration Date | 2021-07-19 |
| Last Update Date | 2022-12-21 |