| NPI | 1861918872 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE60908978) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OR D10786) |
| Enumeration Date | 2017-08-21 |
| Last Update Date | 2019-02-11 |