| NPI | 1790888741 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 50174) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA DDS50174) |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2020-10-22 |