| NPI | 1568775336 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE 60250472) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OR D9462) |
| Enumeration Date | 2010-07-21 |
| Last Update Date | 2011-11-16 |