| NPI | 1174998322 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401415078) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 100009) |
| Enumeration Date | 2015-12-13 |
| Last Update Date | 2016-01-28 |