| NPI | 1164507877 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 49357) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 49357) |
| 1223G0001X Dentist, General Practice (Licence: CA 49357) | |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2024-07-29 |