| NPI | 1174044895 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WA DE61402864) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 33175) |
| Enumeration Date | 2017-07-03 |
| Last Update Date | 2023-05-17 |