| NPI | 1720579378 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: WA DE60800403) |
| Additional Taxonomies | 1223X2210X Dentist, Orofacial Pain (Licence: WA 60800403) |
| 1223G0001X Dentist, General Practice (Licence: WA DE60800403) | |
| Enumeration Date | 2018-05-18 |
| Last Update Date | 2024-09-24 |