| NPI | 1417404146 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: WA DENT.DE.61159964) |
| Additional Taxonomies | 1223X0008X Dentist, Oral and Maxillofacial Radiology (Licence: WA DENT.DE.61159964) |
| Enumeration Date | 2016-09-11 |
| Last Update Date | 2026-03-26 |