| NPI | 1225400120 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE60600842) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OR D10326) |
| Enumeration Date | 2015-10-30 |
| Last Update Date | 2020-07-06 |