| NPI | 1598084352 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CA 59035) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: KS 60704) |
| 1223G0001X Dentist General Practice (Licence: MO 2009020515) | |
| Enumeration Date | 2010-05-19 |
| Last Update Date | 2016-11-10 |