| NPI | 1144359720 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 39456) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AZ D009624) |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2016-12-08 |