| NPI | 1386720993 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: WA DE00010253) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WA DE00010253) |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2018-03-01 |