| NPI | 1114151743 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 10481) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 47555) |
| Enumeration Date | 2009-05-11 |
| Last Update Date | 2013-11-18 |