| NPI | 1598099004 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: UT 5034715-9922) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 12416) |
| Enumeration Date | 2009-09-30 |
| Last Update Date | 2009-09-30 |