| NPI | 1316296916 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: FL DN 20397) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: WA DE60161954) |
| Enumeration Date | 2012-08-29 |
| Last Update Date | 2014-01-09 |