| NPI | 1528287067 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 8449) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA 035012L) |
| 1223G0001X Dentist, General Practice (Licence: CA 61242) | |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2023-06-11 |