| NPI | 1720493265 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 125Q00000X Oral Medicine (Licence: WA DE61322400) |
| Additional Taxonomies | 122300000X Dentist (Licence: WA DE61322400) |
| Enumeration Date | 2014-06-24 |
| Last Update Date | 2025-11-18 |