| NPI | 1124012265 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: WI 1001677-15) |
| Additional Taxonomies | 122300000X Dentist (Licence: GA PDN000003) |
| 122300000X Dentist (Licence: WA de00009745) | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: GA dno13243) | |
| Enumeration Date | 2005-09-05 |
| Last Update Date | 2022-07-21 |