| NPI | 1487099636 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 104407) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0401415125) |
| Enumeration Date | 2013-05-01 |
| Last Update Date | 2022-01-11 |