| NPI | 1467006890 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: WA DE60974439) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: TX 35500) |
| 1223P0300X Dentist, Periodontics (Licence: OR D11946) | |
| Enumeration Date | 2019-07-24 |
| Last Update Date | 2026-08-13 |