| NPI | 1437290970 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE61034038) |
| Additional Taxonomies | 122300000X Dentist (Licence: MN D12616) |
| 1223G0001X Dentist, General Practice (Licence: CA 32091) | |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2025-06-17 |