| NPI | 1962505438 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 54087) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MO 2004014730) |
| 122300000X Dentist (Licence: KS 60530) | |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2011-12-12 |