| NPI | 1528275021 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 55500) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 051516) |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2017-03-06 |