| NPI | 1063792000 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE60437962) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WA 60437962) |
| Enumeration Date | 2011-08-22 |
| Last Update Date | 2018-08-30 |