| NPI | 1619499167 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA 61384541) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WI 1001651-15) |
| 1223G0001X Dentist, General Practice (Licence: IL 019.031262) | |
| Enumeration Date | 2017-07-15 |
| Last Update Date | 2023-09-22 |