| NPI | 1952641243 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NV 6362) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 62045) |
| Enumeration Date | 2013-02-22 |
| Last Update Date | 2015-01-27 |