| NPI | 1942675129 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 65175) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NV 6719) |
| Enumeration Date | 2015-12-14 |
| Last Update Date | 2018-06-15 |