| NPI | 1134352610 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN21524) |
| Additional Taxonomies | 122300000X Dentist (Licence: WA 60309056) |
| Enumeration Date | 2009-08-31 |
| Last Update Date | 2016-06-28 |