| NPI | 1942450416 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 13167) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 57654) |
| Enumeration Date | 2008-09-22 |
| Last Update Date | 2021-07-16 |