| NPI | 1962597856 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 49023) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA 21248) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2008-08-27 |