| NPI | 1912039447 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 62255) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 052725-1) |
| Enumeration Date | 2007-03-11 |
| Last Update Date | 2014-05-14 |