| NPI | 1871759332 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: CA 57250) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 57250) |
| Enumeration Date | 2008-08-04 |
| Last Update Date | 2015-06-04 |