| NPI | 1770667016 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 44707) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS-029944-L) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2020-07-17 |