| NPI | 1467756411 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 109144) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CT 010437) |
| 1223G0001X Dentist, General Practice (Licence: NY 056393) | |
| 1223G0001X Dentist, General Practice (Licence: NY 056393-1) | |
| Enumeration Date | 2011-01-05 |
| Last Update Date | 2025-08-13 |