| NPI | 1306059761 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401415908) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 46238) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2019-07-29 |