| NPI | 1518346949 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0008X Dentist, Oral and Maxillofacial Radiology (Licence: WA DR60561817) |
| Additional Taxonomies | 122300000X Dentist (Licence: WA DE60628679) |
| Enumeration Date | 2015-05-19 |
| Last Update Date | 2025-09-11 |