| NPI | 1235226234 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 27999) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AZ 2796) |
| 1223G0001X Dentist, General Practice (Licence: CO 5549) | |
| 1223G0001X Dentist, General Practice (Licence: OR D6028) | |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2007-07-08 |