| NPI | 1518274166 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 58904) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AZ D 7943) |
| Enumeration Date | 2010-09-02 |
| Last Update Date | 2017-02-12 |