| NPI | 1679823710 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CA DDS101862) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: MA DN1856131) |
| Enumeration Date | 2012-09-17 |
| Last Update Date | 2021-04-20 |