| NPI | 1215151618 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 55733) |
| Additional Taxonomies | 122300000X Dentist (Licence: MD 13177) |
| 122300000X Dentist (Licence: AK 1568) | |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2015-05-12 |