| NPI | 1366761389 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL FC DN 19528) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WA DE60156700) |
| Enumeration Date | 2010-06-01 |
| Last Update Date | 2013-09-27 |