| NPI | 1942470422 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL dn18205) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA dds101016) |
| Enumeration Date | 2008-03-11 |
| Last Update Date | 2019-12-03 |