| NPI | 1750515417 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 50351) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA CA-50351) |
| Enumeration Date | 2009-05-11 |
| Last Update Date | 2009-05-11 |