| NPI | 1134363286 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 26221) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 59324) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 59324) | |
| Enumeration Date | 2009-04-20 |
| Last Update Date | 2022-07-16 |