| NPI | 1144213844 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WA DE00008827) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: WA DE00008827) |
| Enumeration Date | 2005-08-26 |
| Last Update Date | 2020-04-30 |