| NPI | 1801289319 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: WA DE61002648) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: WA MD61157248) |
| 204E00000X Oral & Maxillofacial Surgery (Licence: WA MDRE.ML.60875753) | |
| 204E00000X Oral & Maxillofacial Surgery (Licence: WA 60555334) | |
| 208600000X Surgery (Licence: WA MD61157248) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-03-07 |
| Last Update Date | 2021-09-29 |