| NPI | 1508143389 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 106125) |
| Additional Taxonomies | 122300000X Dentist (Licence: NC 9196) |
| Enumeration Date | 2011-11-08 |
| Last Update Date | 2023-07-31 |