| NPI | 1881823920 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CA 107827) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: TX 24610) |
| Enumeration Date | 2009-07-10 |
| Last Update Date | 2022-11-08 |