| NPI | 1568020352 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: WA DE61556525) |
| Additional Taxonomies | 1223X2210X Dentist, Orofacial Pain (Licence: WA DE61556525) |
| 122300000X Dentist (Licence: WA DE61556525) | |
| Enumeration Date | 2019-06-05 |
| Last Update Date | 2025-09-27 |