| NPI | 1700057429 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 49617) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: KS 019025819) |
| Enumeration Date | 2008-03-20 |
| Last Update Date | 2008-07-30 |