| NPI | 1366518474 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ D06970) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 55021) |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2016-03-02 |