| NPI | 1790890176 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 57896) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TN 8296) |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2009-08-25 |