| NPI | 1639467111 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN19461) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WA DE60225187) |
| Enumeration Date | 2011-07-18 |
| Last Update Date | 2023-02-21 |