| NPI | 1982914222 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 59681) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NM DD3405) |
| Enumeration Date | 2010-10-20 |
| Last Update Date | 2010-10-20 |