| NPI | 1861365587 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WA DE70022954) |
| Additional Taxonomies | 1223X2210X Dentist, Orofacial Pain (Licence: WA DE70022954) |
| Enumeration Date | 2025-09-29 |
| Last Update Date | 2025-09-29 |