| NPI | 1629591789 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WA 60740698) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WA DE60740698) |
| Enumeration Date | 2017-07-20 |
| Last Update Date | 2024-09-05 |