| NPI | 1700129418 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE60343087) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 28620) |
| Enumeration Date | 2013-04-01 |
| Last Update Date | 2013-04-01 |