| NPI | 1386892859 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE60511881) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OR D9186) |
| Enumeration Date | 2008-09-08 |
| Last Update Date | 2020-10-20 |