| NPI | 1861710378 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: CA 54766) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 54766) |
| Enumeration Date | 2010-05-07 |
| Last Update Date | 2010-10-15 |