| NPI | 1265650808 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: HI 2659) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: WA DE7852) |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2018-09-24 |