| NPI | 1033764592 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 101973) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 101973) |
| Enumeration Date | 2019-08-01 |
| Last Update Date | 2023-02-13 |