| NPI | 1265784367 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA SP290) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 28450) |
| Enumeration Date | 2012-10-12 |
| Last Update Date | 2021-12-20 |