| NPI | 1497988075 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 53956) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: CA 53956) |
| Enumeration Date | 2009-08-28 |
| Last Update Date | 2010-11-07 |