| NPI | 1851605372 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CA 59493) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: IN 12011405A) |
| Enumeration Date | 2010-07-27 |
| Last Update Date | 2010-07-27 |