| NPI | 1306152145 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 61125) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NV 6000) |
| Enumeration Date | 2010-08-30 |
| Last Update Date | 2018-08-13 |