| NPI | 1487822177 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CA 46515) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 46515) |
| Enumeration Date | 2008-02-14 |
| Last Update Date | 2013-08-14 |