| NPI | 1073650552 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OR D11608) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 54789) |
| 122300000X Dentist (Licence: UT 11417672-9921) | |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2022-10-11 |