| NPI | 1588825418 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 60884) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA 10047) |
| 1223G0001X Dentist, General Practice (Licence: TX 24513) | |
| Enumeration Date | 2008-06-23 |
| Last Update Date | 2014-10-17 |