| NPI | 1063688349 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 58097) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY P58992) |
| Enumeration Date | 2008-05-06 |
| Last Update Date | 2009-03-11 |