| NPI | 1902128390 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 37436) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: HI DT-1473) |
| Enumeration Date | 2010-02-25 |
| Last Update Date | 2010-02-25 |