| NPI | 1326513144 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WA DE60740109) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 102068) |
| 122300000X Dentist (Licence: AZ D012333) | |
| Enumeration Date | 2018-10-08 |
| Last Update Date | 2025-05-05 |