| NPI | 1457799728 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: WA DE60482650) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 29028) |
| 122300000X Dentist (Licence: WA DR60371551) | |
| Enumeration Date | 2013-06-10 |
| Last Update Date | 2025-08-18 |