| NPI | 1598380362 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE61231061) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IA DDS-09753) |
| Enumeration Date | 2020-06-08 |
| Last Update Date | 2022-05-09 |