| NPI | 1720287238 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WA DE00011156) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 59379) |
| Enumeration Date | 2007-07-13 |
| Last Update Date | 2024-10-08 |