| NPI | 1386771905 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 54079) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NM DD1787) |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2019-04-10 |