| NPI | 1962546606 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NV 5494) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: CA 55461) |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2008-06-23 |