| NPI | 1821330671 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 63996) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PR 003010) |
| Enumeration Date | 2013-03-20 |
| Last Update Date | 2016-04-10 |