| NPI | 1467927152 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE60892442) |
| Additional Taxonomies | 122300000X Dentist (Licence: WA DE60892442) |
| Enumeration Date | 2018-10-09 |
| Last Update Date | 2021-06-24 |