| NPI | 1912745928 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE61657543) |
| Additional Taxonomies | 122300000X Dentist (Licence: AZ D012268) |
| Enumeration Date | 2024-07-16 |
| Last Update Date | 2025-06-20 |