| NPI | 1306339866 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE61459742) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 34205) |
| Enumeration Date | 2018-06-10 |
| Last Update Date | 2024-03-21 |