| NPI | 1821087446 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 56448) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CO 9002) |
| Enumeration Date | 2005-10-17 |
| Last Update Date | 2009-02-05 |