| NPI | 1184786790 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 41931) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA B41931-01) |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2007-07-08 |