| NPI | 1962665091 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 55057) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 55057) |
| Enumeration Date | 2008-07-09 |
| Last Update Date | 2012-07-24 |