| NPI | 1154625408 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: CA 61883) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: VA 0401413018) |
| Enumeration Date | 2010-12-30 |
| Last Update Date | 2014-02-06 |