| NPI | 1952532251 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: WA DE60425213) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 24686) |
| Enumeration Date | 2009-08-04 |
| Last Update Date | 2025-06-03 |