| NPI | 1588119846 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: VA 0401416156) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: CA 100726) |
| Enumeration Date | 2016-08-16 |
| Last Update Date | 2020-12-31 |