| NPI | 1174018733 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN23971) |
| Additional Taxonomies | 122300000X Dentist (Licence: OR D11220) |
| 122300000X Dentist (Licence: WA DE60985534) | |
| Enumeration Date | 2018-06-26 |
| Last Update Date | 2022-10-29 |