| NPI | 1598078206 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE60159566) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 59473) |
| Enumeration Date | 2010-07-22 |
| Last Update Date | 2013-06-18 |