| NPI | 1881857126 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 59142) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MI 2901019836) |
| Enumeration Date | 2008-07-07 |
| Last Update Date | 2018-04-13 |