| NPI | 1740596485 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 59517) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MT DEN-DEN-LIC-6057) |
| Enumeration Date | 2010-08-18 |
| Last Update Date | 2015-06-24 |