| NPI | 1518350032 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D10410) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WA DE60653976) |
| Enumeration Date | 2015-03-09 |
| Last Update Date | 2016-08-02 |