| NPI | 1265777114 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: CA BW1389255) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 37181) |
| Enumeration Date | 2012-12-04 |
| Last Update Date | 2012-12-04 |