| NPI | 1568510014 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: ID D-4884) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: CA 48885) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2018-05-01 |