| NPI | 1437762473 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WA DE61219783) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OR D11300) |
| Enumeration Date | 2020-08-28 |
| Last Update Date | 2022-02-01 |