| NPI | 1518246412 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 64672) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NM DD3551) |
| Enumeration Date | 2011-08-09 |
| Last Update Date | 2015-10-27 |