| NPI | 1306109780 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TN 12135) |
| Additional Taxonomies | 122300000X Dentist (Licence: WA DE60294531) |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: WA DE60294531) | |
| Enumeration Date | 2012-06-20 |
| Last Update Date | 2024-04-16 |