| NPI | 1952500365 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: IA 08614) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: CA 52861) |
| Enumeration Date | 2007-07-16 |
| Last Update Date | 2009-08-19 |