| NPI | 1457768251 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: WA DE60473831) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WA DE60473831) |
| 122300000X Dentist (Licence: WA DE60473831) | |
| Enumeration Date | 2014-07-14 |
| Last Update Date | 2025-03-28 |