| NPI | 1558383034 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 63238) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NH 3042) |
| 1223G0001X Dentist, General Practice (Licence: MA 18978) | |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2021-10-06 |