| NPI | 1114017977 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 57715) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NV 4912) |
| 122300000X Dentist (Licence: CA 57715) | |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2013-12-11 |