| NPI | 1154452415 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 53167) |
| Additional Taxonomies | 122300000X Dentist (Licence: IN 12010060A) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2013-04-27 |