| NPI | 1285912048 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 60427) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NM DD3550) |
| Enumeration Date | 2011-07-28 |
| Last Update Date | 2021-08-01 |