| NPI | 1306393004 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 105611) |
| Additional Taxonomies | 122300000X Dentist (Licence: WA DE60680606) |
| Enumeration Date | 2016-09-09 |
| Last Update Date | 2020-11-17 |