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 |