| NPI | 1497719850 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 122300000X Dentist (Licence: CA D42551) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS-027340-L) |
| Enumeration Date | 2006-04-13 |
| Last Update Date | 2007-07-08 |