| NPI | 1003161969 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 61342) |
| Additional Taxonomies | 1223D0001X Dentist, Dental Public Health (Licence: CA 61342) |
| Enumeration Date | 2012-07-17 |
| Last Update Date | 2016-08-11 |