| NPI | 1437686920 |
|---|---|
| Professional Name | N/A N/A N/A |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: WA DE60876116) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2017-05-16 |
| Last Update Date | 2023-01-14 |