| NPI | 1255426821 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 43338) |
| Additional Taxonomies | 122300000X Dentist (Licence: HI DT-1929) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2012-02-23 |