| NPI | 1588078661 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA DDS105416) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0401415854) |
| 1223G0001X Dentist, General Practice (Licence: PA DS040863) | |
| 1223G0001X Dentist, General Practice (Licence: DC DEN1001777) | |
| 1223G0001X Dentist, General Practice (Licence: NY 057329) | |
| Enumeration Date | 2014-06-17 |
| Last Update Date | 2020-09-18 |