| NPI | 1154730349 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 48699) |
| Additional Taxonomies | 1223D0001X Dentist, Dental Public Health (Licence: CA 48699) |
| Enumeration Date | 2014-08-12 |
| Last Update Date | 2014-08-12 |