| NPI | 1295069045 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WA DE60487956) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NJ 22d102422200) |
| Enumeration Date | 2009-09-28 |
| Last Update Date | 2024-12-26 |