| NPI | 1891877379 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ D008132) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA D46922) |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2014-12-19 |