| NPI | 1376708958 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OR D9140) |
| Additional Taxonomies | 122300000X Dentist (Licence: WA DE61317777) |
| Enumeration Date | 2008-07-23 |
| Last Update Date | 2026-04-02 |