| NPI | 1669770442 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NE 6928) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NE 6928) |
| 1223G0001X Dentist, General Practice (Licence: CA 102174) | |
| Enumeration Date | 2011-03-03 |
| Last Update Date | 2017-11-30 |