| NPI | 1356586812 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 9271) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 56280) |
| Enumeration Date | 2008-12-11 |
| Last Update Date | 2015-12-19 |