| NPI | 1871127894 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WA DE60959287) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: WA DE60959287) |
| Enumeration Date | 2020-02-28 |
| Last Update Date | 2025-03-27 |