| NPI | 1881794634 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WA 8359) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: WA DE00008359) |
| 1223G0001X Dentist, General Practice (Licence: WA 8359) | |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2010-06-15 |