| NPI | 1164705679 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA DN63067) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL DN19505) |
| Enumeration Date | 2011-09-21 |
| Last Update Date | 2020-02-20 |