| NPI | 1023271053 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 105995) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA 22205) |
| Enumeration Date | 2008-07-09 |
| Last Update Date | 2025-04-15 |