| NPI | 1699174532 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401415325) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 63918) |
| Enumeration Date | 2014-08-15 |
| Last Update Date | 2017-12-13 |