NPI | 1780160333 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA 60861734) |
Additional Taxonomies | 122300000X Dentist (Licence: WA DE60861734) |
Enumeration Date | 2018-07-17 |
Last Update Date | 2024-08-07 |