| NPI | 1275765869 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 64217) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MD 14619) |
| Enumeration Date | 2009-08-14 |
| Last Update Date | 2022-06-06 |