| NPI | 1215284195 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 64665) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CT 10830) |
| Enumeration Date | 2012-08-09 |
| Last Update Date | 2016-12-07 |