| NPI | 1275521072 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA DDS105814) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WA DE00009812) |
| Enumeration Date | 2005-10-06 |
| Last Update Date | 2021-07-11 |