| NPI | 1285017301 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 125Q00000X Oral Medicine (Licence: WA DE60575271) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WA DE60575271) |
| Enumeration Date | 2015-07-07 |
| Last Update Date | 2024-06-03 |