| NPI | 1871867069 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: WA DE60665049) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0401413488) |
| Enumeration Date | 2012-03-06 |
| Last Update Date | 2020-08-24 |