| NPI | 1154751139 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE60609735) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 63077) |
| Enumeration Date | 2013-11-12 |
| Last Update Date | 2022-07-21 |