| NPI | 1356500839 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: CA 59407) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 59407) |
| 1223G0001X Dentist, General Practice (Licence: MI 2901019793) | |
| Enumeration Date | 2008-06-09 |
| Last Update Date | 2018-06-27 |