| NPI | 1871893008 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: WA DE 60147287) |
| Additional Taxonomies | 1223D0004X Dentist, Dentist Anesthesiologist Speciality (Licence: WA GA60178267) |
| Enumeration Date | 2010-10-21 |
| Last Update Date | 2023-12-22 |