| NPI | 1912087164 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 53345) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA A91989) |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2019-04-25 |