| NPI | 1144977687 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN30054) |
| Additional Taxonomies | 122300000X Dentist (Licence: WA 61426269) |
| 122300000X Dentist (Licence: WA DR61286418) | |
| Enumeration Date | 2022-03-04 |
| Last Update Date | 2025-05-12 |