| NPI | 1801908298 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 38045) |
| Additional Taxonomies | 122400000X Denturist (Licence: CA 38045) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2007-07-08 |