| NPI | 1922376821 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 40617) |
| Additional Taxonomies | 1223P0700X Dentist Prosthodontics (Licence: CA 40617) |
| Enumeration Date | 2011-12-06 |
| Last Update Date | 2011-12-06 |