NPI | 1366576704 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: WA DE00008096) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 32587) |
1223G0001X Dentist, General Practice (Licence: WA 8096) | |
Enumeration Date | 2007-03-16 |
Last Update Date | 2014-04-24 |