| NPI | 1265588586 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE00010493) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 50508) |
| Enumeration Date | 2007-01-27 |
| Last Update Date | 2007-07-08 |