| NPI | 1588228381 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WA DE60938413) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WA 60938413) |
| Enumeration Date | 2019-04-26 |
| Last Update Date | 2021-05-06 |