| NPI | 1437440260 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: CA 60257) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: FL DN17300) |
| Enumeration Date | 2011-04-27 |
| Last Update Date | 2016-06-10 |