| NPI | 1538365960 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 58138) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: HI 2299) |
| Enumeration Date | 2007-06-22 |
| Last Update Date | 2009-05-08 |