| NPI | 1467061978 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE61088797) |
| Additional Taxonomies | 122300000X Dentist (Licence: WA TP61089695) |
| Enumeration Date | 2020-07-30 |
| Last Update Date | 2023-04-24 |