| NPI | 1255870903 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA 61151751) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OR D10921) |
| Enumeration Date | 2017-02-14 |
| Last Update Date | 2024-09-28 |