| NPI | 1689654873 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 64293) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: SC 8256) |
| 1223G0001X Dentist, General Practice (Licence: MD 14022) | |
| 1223G0001X Dentist, General Practice (Licence: PA ds036262) | |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2018-04-04 |