| NPI | 1730313677 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 60246) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NV 5759) |
| Enumeration Date | 2009-05-06 |
| Last Update Date | 2013-04-21 |