| NPI | 1205514809 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AZ D012370) |
| Additional Taxonomies | 122300000X Dentist (Licence: WA RR61435858) |
| Enumeration Date | 2023-07-05 |
| Last Update Date | 2025-02-11 |