| NPI | 1295191732 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: PA DS040563) |
| Additional Taxonomies | 122300000X Dentist (Licence: WA DE60634985) |
| 1223G0001X Dentist, General Practice (Licence: WA DE60634985) | |
| Enumeration Date | 2016-01-13 |
| Last Update Date | 2024-10-23 |