| NPI | 1881704963 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: WA 00008625) |
| Additional Taxonomies | 122300000X Dentist (Licence: WA 8625) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2024-05-01 |