| NPI | 1699825745 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 47841) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MT 2049) |
| 1223G0001X Dentist, General Practice (Licence: CO 9255) | |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2007-07-08 |