| NPI | 1689682635 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CA 53336) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: MD 13524) |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2014-07-10 |