| NPI | 1508048687 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D12165) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 56270) |
| Enumeration Date | 2007-11-30 |
| Last Update Date | 2025-12-01 |