| NPI | 1619071156 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE00010187) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 53718) |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2007-07-08 |