| NPI | 1215076369 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 35007) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: KS 5758) |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2007-07-08 |