| NPI | 1033453667 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: CA 61647) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 61647) |
| Enumeration Date | 2012-11-20 |
| Last Update Date | 2023-07-31 |