| NPI | 1427216829 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: WA DE60545349) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL DN17949) |
| Enumeration Date | 2008-06-02 |
| Last Update Date | 2023-09-26 |