| NPI | 1437605698 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WA DE61074305) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 100775) |
| Enumeration Date | 2016-08-28 |
| Last Update Date | 2020-11-17 |