| NPI | 1265957179 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA DDS102481) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS041499) |
| Enumeration Date | 2017-08-11 |
| Last Update Date | 2019-12-17 |