| NPI | 1265952006 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE61205989) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 33094) |
| Enumeration Date | 2017-06-22 |
| Last Update Date | 2023-04-28 |