| NPI | 1962787739 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE60239342) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OR D9559) |
| Enumeration Date | 2011-10-12 |
| Last Update Date | 2016-04-05 |