| NPI | 1245472125 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: OR D9026) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 49680) |
| 122300000X Dentist (Licence: WA DE9182) | |
| Enumeration Date | 2009-03-24 |
| Last Update Date | 2009-03-24 |