| NPI | 1750604823 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D9380) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NE D6871) |
| 1223G0001X Dentist, General Practice (Licence: WA DE60226390) | |
| Enumeration Date | 2010-03-03 |
| Last Update Date | 2013-10-28 |