| NPI | 1982496733 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WA DE70003488) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WA DE70003488) |
| Enumeration Date | 2025-05-19 |
| Last Update Date | 2025-07-10 |