| NPI | 1265681266 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 60545) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 054566) |
| Enumeration Date | 2008-09-15 |
| Last Update Date | 2015-02-06 |