| NPI | 1497300305 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN26711) |
| Additional Taxonomies | 122300000X Dentist (Licence: WA DE60972402) |
| Enumeration Date | 2019-08-07 |
| Last Update Date | 2022-05-09 |