| NPI | 1457530651 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: CA 56089) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 56089) |
| Enumeration Date | 2007-10-24 |
| Last Update Date | 2012-02-08 |