| NPI | 1194984104 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CA 47136) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: WA 8355) |
| 1223G0001X Dentist General Practice (Licence: AZ 5836) | |
| Enumeration Date | 2008-06-04 |
| Last Update Date | 2015-01-10 |