| NPI | 1134615578 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA D.E.60861717) |
| Additional Taxonomies | 122300000X Dentist (Licence: WA D.E.60861717) |
| Enumeration Date | 2018-07-09 |
| Last Update Date | 2022-10-11 |