| NPI | 1194954180 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 59622) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 390200000x) |
| Enumeration Date | 2009-07-10 |
| Last Update Date | 2017-01-05 |