| NPI | 1568559334 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 48065) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA 19722) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2020-09-18 |