| NPI | 1619093929 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 64458) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AZ D6481) |
| 1223G0001X Dentist, General Practice (Licence: FL DN17000) | |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2015-06-22 |