| NPI | 1417122268 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 55684) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA 21788) |
| Enumeration Date | 2008-04-23 |
| Last Update Date | 2010-11-29 |