| NPI | 1376790725 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 57324) |
| Additional Taxonomies | 126800000X Dental Assistant (Licence: CA 63088) |
| Enumeration Date | 2008-08-27 |
| Last Update Date | 2009-09-28 |