| NPI | 1114352176 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN22910) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 62913) |
| Enumeration Date | 2013-09-10 |
| Last Update Date | 2017-08-17 |