| NPI | 1497082739 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 102294) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 044505) |
| Enumeration Date | 2009-11-06 |
| Last Update Date | 2019-01-09 |