| NPI | 1639557739 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA DDS105848) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DN1857629) |
| 1223G0001X Dentist, General Practice (Licence: CA 105848) | |
| Enumeration Date | 2015-05-11 |
| Last Update Date | 2021-06-23 |