| NPI | 1700897733 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NV 3077) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 41858) |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2007-07-08 |