| NPI | 1336232339 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: WA DE00009934) | 
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WA DE00009934) | 
| Enumeration Date | 2006-10-02 | 
| Last Update Date | 2022-10-04 |