| NPI | 1962513382 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WA 10402) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CO DEN-9034) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2008-01-25 |