| NPI | 1700972171 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223D0004X Dentist, Dentist Anesthesiologist Speciality (Licence: CA 1174) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA D44339) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2013-05-28 |