| NPI | 1891129698 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OR D9932) |
| Additional Taxonomies | 122300000X Dentist (Licence: WA DE60435827) |
| Enumeration Date | 2013-08-28 |
| Last Update Date | 2019-01-03 |