| NPI | 1346234721 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 52198) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NC 5412) |
| Enumeration Date | 2005-08-31 |
| Last Update Date | 2009-01-28 |