| NPI | 1366775793 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 58572) |
| Additional Taxonomies | 1223D0001X Dentist, Dental Public Health (Licence: CA 58572) |
| 1223G0001X Dentist, General Practice (Licence: CA 58572) | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 58572) | |
| 1223P0300X Dentist, Periodontics (Licence: CA 58572) | |
| Enumeration Date | 2009-09-17 |
| Last Update Date | 2011-12-12 |