| NPI | 1619022936 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 48153) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 000035) |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2020-03-20 |