| NPI | 1538542980 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 101151) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AZ 9214) |
| Enumeration Date | 2015-07-02 |
| Last Update Date | 2018-03-17 |