| NPI | 1710967252 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: WA DE00009207) |
| Additional Taxonomies | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: OR D10787) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CO D9281) | |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2021-12-22 |