| NPI | 1265543003 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WA DE60240538) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: TX 19550) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2020-12-18 |