| NPI | 1306523436 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DENT.DE.70004365) |
| Additional Taxonomies | 122300000X Dentist (Licence: WA DENT.DE.70004365) |
| Enumeration Date | 2023-06-30 |
| Last Update Date | 2025-08-19 |