| NPI | 1790858850 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NV 7149) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 53970) |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2022-01-19 |