| NPI | 1275513194 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA 10030) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WA DE00010030) |
| Enumeration Date | 2006-01-18 |
| Last Update Date | 2013-07-03 |