| NPI | 1437370582 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE 60447313) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 54679) |
| 1223G0001X Dentist, General Practice (Licence: KY 8846) | |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2014-11-24 |