| NPI | 1013914886 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ 5716) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 50766) |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2007-07-08 |