| NPI | 1881894376 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: OR D9222) |
| Additional Taxonomies | 122300000X Dentist (Licence: OR D9222) |
| 122300000X Dentist (Licence: WA DE00011251) | |
| Enumeration Date | 2007-07-23 |
| Last Update Date | 2021-04-26 |