| NPI | 1598295354 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WA DE60757252) |
| Additional Taxonomies | 122300000X Dentist (Licence: WA 600757252) |
| Enumeration Date | 2017-06-14 |
| Last Update Date | 2017-06-14 |