| NPI | 1881856383 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: CA 60106) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: FL 495) |
| Enumeration Date | 2008-06-26 |
| Last Update Date | 2012-10-18 |