| NPI | 1427360940 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: CA 101209) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 101209) |
| 1223G0001X Dentist, General Practice (Licence: NY 056566) | |
| 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: NY 056566) | |
| Enumeration Date | 2010-07-13 |
| Last Update Date | 2018-08-07 |