| NPI | 1376276915 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WA DE61434173) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL DRPM2504) |
| Enumeration Date | 2022-07-01 |
| Last Update Date | 2023-06-14 |