| NPI | 1700941986 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: WA DE00009468) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: WA 9468) |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2023-05-19 |