| NPI | 1386319150 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NM DD5501) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WA DE61319274) |
| Enumeration Date | 2021-08-12 |
| Last Update Date | 2022-07-15 |