| NPI | 1366773079 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: WA DE60018757) |
| Additional Taxonomies | 1223D0001X Dentist Dental Public Health (Licence: WA DE60018757) |
| Enumeration Date | 2010-01-20 |
| Last Update Date | 2010-01-20 |