| NPI | 1639548803 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA DDS104307) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA DN1857073) |
| Enumeration Date | 2015-09-17 |
| Last Update Date | 2019-09-25 |