| NPI | 1245254374 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 58818) |
| Additional Taxonomies | 122300000X Dentist (Licence: MI 2901018718) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2009-12-19 |