| NPI | 1508347501 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE61299583) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA DDS103051) |
| Enumeration Date | 2018-08-27 |
| Last Update Date | 2022-07-19 |