| NPI | 1851063564 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA 61562941) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA DDS106727) |
| 1223G0001X Dentist, General Practice (Licence: CA DDS106727) | |
| Enumeration Date | 2021-09-30 |
| Last Update Date | 2025-01-09 |