| NPI | 1013961853 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 52752) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: CA 52752) |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2007-07-08 |