| NPI | 1295004760 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 60097) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 25643) |
| Enumeration Date | 2011-12-29 |
| Last Update Date | 2017-07-06 |