| NPI | 1053841338 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA DDS101365) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: CA D101365) |
| Enumeration Date | 2017-06-19 |
| Last Update Date | 2018-03-17 |