| NPI | 1750392585 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 10166) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 50891) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2010-12-29 |