| NPI | 1518053370 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 0401415382) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 54366) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2019-10-29 |