| NPI | 1295123982 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 30659) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WA DE60497595) |
| Enumeration Date | 2015-01-02 |
| Last Update Date | 2015-03-16 |