| NPI | 1023756863 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: GU D-1046) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA DDS106461) |
| Enumeration Date | 2022-05-23 |
| Last Update Date | 2025-11-11 |