| NPI | 1548400369 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 27260) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WA DE00008410) |
| Enumeration Date | 2009-03-06 |
| Last Update Date | 2011-08-11 |