| NPI | 1851558381 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 56948) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS036356) |
| Enumeration Date | 2008-05-21 |
| Last Update Date | 2013-04-16 |