| NPI | 1669452108 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NM DD5099) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 54058) |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2019-07-19 |