| NPI | 1720527898 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: WA DE60658473) |
| Additional Taxonomies | 122300000X Dentist (Licence: WA DE60658473) |
| Enumeration Date | 2017-02-22 |
| Last Update Date | 2021-04-16 |