| NPI | 1649309543 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 61162) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NC 150551) |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2014-02-23 |