| NPI | 1801820725 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NM DD2901) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 42561) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2007-10-27 |