| NPI | 1548454457 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: CA D 40501) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA D40501) |
| Enumeration Date | 2007-09-04 |
| Last Update Date | 2007-10-27 |