| NPI | 1932518628 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WA DE60880906) |
| Additional Taxonomies | 1223D0001X Dentist, Dental Public Health (Licence: MN D13066) |
| Enumeration Date | 2014-08-06 |
| Last Update Date | 2021-03-17 |