| NPI | 1285003301 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA de60584613) |
| Additional Taxonomies | 122300000X Dentist (Licence: WA DE60584613) |
| Enumeration Date | 2015-09-18 |
| Last Update Date | 2024-12-12 |