| NPI | 1275390833 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OR D12168) |
| Additional Taxonomies | 122300000X Dentist (Licence: WA DE70001919) |
| Enumeration Date | 2024-02-29 |
| Last Update Date | 2026-03-11 |