| NPI | 1740821628 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN122233) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WA DE60997278) |
| Enumeration Date | 2019-10-02 |
| Last Update Date | 2021-07-06 |