| NPI | 1841330198 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist Periodontics (Licence: CA 54265) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: CA 54265) |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2015-09-07 |