| NPI | 1689868242 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 106962) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 0534651) |
| Enumeration Date | 2007-08-28 |
| Last Update Date | 2022-11-03 |