| NPI | 1376621599 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CA DDS62414) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: NY 38937-1) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2022-07-21 |