| NPI | 1619581188 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE61474931) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NV 7409) |
| Enumeration Date | 2020-09-02 |
| Last Update Date | 2023-12-22 |