| NPI | 1144238049 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 122300000X Dentist (Licence: NV 3732) | 
| Additional Taxonomies | 122300000X Dentist (Licence: CA 47260) | 
| 122300000X Dentist (Licence: AZ 5308) | |
| Enumeration Date | 2006-08-04 | 
| Last Update Date | 2007-07-08 |