| NPI | 1518417419 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO DEN.00205075) |
| Additional Taxonomies | 122300000X Dentist (Licence: WA DE60665342) |
| Enumeration Date | 2016-10-04 |
| Last Update Date | 2022-06-02 |