| NPI | 1174872766 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: HI DT2586) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 61813) |
| Enumeration Date | 2012-08-29 |
| Last Update Date | 2018-03-17 |