| NPI | 1316502263 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: KY 10730) |
| Additional Taxonomies | 122300000X Dentist (Licence: WA DE60951887) |
| Enumeration Date | 2019-05-07 |
| Last Update Date | 2023-09-01 |