| NPI | 1356412647 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 43769) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: CA 43769) |
| Enumeration Date | 2006-11-10 |
| Last Update Date | 2020-02-10 |