| NPI | 1720006430 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D8298) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WA DE00010608) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2019-04-02 |