| NPI | 1801848254 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WA DE60829595) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AZ D6663) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2020-12-15 |