| NPI | 1649429044 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: WA DE00008511) | 
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: WA DE0008511) | 
| Enumeration Date | 2008-09-10 | 
| Last Update Date | 2019-08-28 |