| NPI | 1952527616 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: UT 482-7752-9922) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 45326) |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2007-07-08 |