| NPI | 1932516929 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WA DE61289001) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 059007) |
| Enumeration Date | 2014-07-22 |
| Last Update Date | 2025-04-14 |