| NPI | 1477956175 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 63849) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 63849) |
| Enumeration Date | 2014-10-08 |
| Last Update Date | 2022-01-06 |