| NPI | 1598371866 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WA DE61078545) |
| Additional Taxonomies | 122300000X Dentist (Licence: WA 61078545) |
| Enumeration Date | 2020-09-21 |
| Last Update Date | 2020-09-21 |