| NPI | 1073533808 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 51752) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS023024L) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2016-10-24 |