| NPI | 1881686251 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 56102) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 052444) |
| Enumeration Date | 2005-08-22 |
| Last Update Date | 2007-09-28 |