| NPI | 1245365394 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: AK 1121) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: WA 9405) |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2007-07-08 |