| NPI | 1851723472 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 63215) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OR D9923) |
| Enumeration Date | 2013-08-06 |
| Last Update Date | 2016-09-21 |