| NPI | 1558867440 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE61422293) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MN D14064) |
| Enumeration Date | 2018-04-01 |
| Last Update Date | 2023-06-02 |