| NPI | 1649915307 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WA 61305709) |
| Additional Taxonomies | 122300000X Dentist (Licence: OR D11812) |
| 122300000X Dentist (Licence: MS 4389-23) | |
| 122300000X Dentist (Licence: WI 6001294-15) | |
| Enumeration Date | 2022-04-27 |
| Last Update Date | 2023-07-12 |