| NPI | 1386885002 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NM DD3689) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 58114) |
| Enumeration Date | 2009-03-09 |
| Last Update Date | 2013-01-30 |