| NPI | 1861617581 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 59105) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: LA S-462) |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2012-02-01 |