| NPI | 1558712083 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA DDS102197) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: ME DEN4489) |
| Enumeration Date | 2016-06-27 |
| Last Update Date | 2018-03-17 |