| NPI | 1558885962 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA 60773984) |
| Additional Taxonomies | 122300000X Dentist (Licence: WA 60773984) |
| Enumeration Date | 2017-07-27 |
| Last Update Date | 2025-01-09 |