| NPI | 1730242157 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE10033) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OR D8441) |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2011-07-18 |