| NPI | 1407001167 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 58268) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NV 5778) |
| Enumeration Date | 2008-11-22 |
| Last Update Date | 2009-09-12 |