| NPI | 1770586422 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 56718) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CO 8789) |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2008-11-21 |