| NPI | 1891170221 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 101134) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AL 6229) |
| Enumeration Date | 2015-07-27 |
| Last Update Date | 2017-01-16 |