| NPI | 1306033584 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CA 57126) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: MA 21987) |
| Enumeration Date | 2007-10-01 |
| Last Update Date | 2008-06-25 |