| NPI | 1326239773 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 57711) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA 9559) |
| Enumeration Date | 2007-08-09 |
| Last Update Date | 2020-08-19 |