| NPI | 1114221819 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 54132) |
| Additional Taxonomies | 126800000X Dental Assistant (Licence: CA 49001) |
| Enumeration Date | 2011-01-10 |
| Last Update Date | 2011-01-10 |