| NPI | 1740684562 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 103709) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: CA 28679) |
| Enumeration Date | 2014-10-22 |
| Last Update Date | 2019-05-29 |