| NPI | 1891814760 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 60282) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 051231-1) |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2021-05-10 |