| NPI | 1912255860 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 61843) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 61843) |
| Enumeration Date | 2012-08-27 |
| Last Update Date | 2019-07-19 |