| NPI | 1548321979 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 53614) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AZ D6495) |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2013-04-12 |