| NPI | 1174747968 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 56618) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 20363) |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2011-12-02 |