| NPI | 1720380595 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 59936) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: CA 59936) |
| Enumeration Date | 2010-11-29 |
| Last Update Date | 2020-11-11 |