| NPI | 1356762934 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 100083) |
| Additional Taxonomies | 122300000X Dentist (Licence: TN 9794) |
| Enumeration Date | 2013-12-26 |
| Last Update Date | 2019-03-11 |