| NPI | 1205973393 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL 27179) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 55432) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2022-08-08 |