| NPI | 1669475406 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: WA DE00006084) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: WA 6084) |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2009-11-06 |