| NPI | 1366655524 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 55534) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AZ D7111) |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2017-07-31 |