| NPI | 1295259125 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA 60765347) |
| Additional Taxonomies | 122300000X Dentist (Licence: WA DE60765347) |
| Enumeration Date | 2017-08-02 |
| Last Update Date | 2025-01-16 |