| NPI | 1285161547 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: WA DF61606337) |
| Additional Taxonomies | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: OH 71.000286) |
| Enumeration Date | 2017-05-17 |
| Last Update Date | 2025-10-22 |