| NPI | 1083837181 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CA 51411) |
| Additional Taxonomies | 1223E0200X Dentist Endodontics (Licence: CA 49173) |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2018-07-09 |