| NPI | 1962137356 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE61475766) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OR D11640) |
| Enumeration Date | 2022-07-19 |
| Last Update Date | 2023-11-06 |