| NPI | 1003919127 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 54027) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA DDS54027) |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2013-08-23 |