| NPI | 1437630068 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: OR D10924) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: WA DE60884004) |
| Enumeration Date | 2018-08-22 |
| Last Update Date | 2021-07-15 |