| NPI | 1871867671 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OR D10165) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 60690) |
| 122300000X Dentist (Licence: WA DE60402594) | |
| Enumeration Date | 2012-02-27 |
| Last Update Date | 2016-09-30 |