| NPI | 1609843374 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: WA DE00006886) |
| Additional Taxonomies | 122300000X Dentist (Licence: WA 6886) |
| Enumeration Date | 2006-03-02 |
| Last Update Date | 2015-11-12 |