| NPI | 1174551972 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: WA DE60262499) |
| Additional Taxonomies | 122300000X Dentist (Licence: WA DE-60262499) |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2023-04-14 |