| NPI | 1033389945 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223D0004X Dentist Dentist Anesthesiologist (Licence: CA 48725) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 48725) |
| Enumeration Date | 2008-03-06 |
| Last Update Date | 2014-02-20 |