| NPI | 1033788245 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 112207) |
| Additional Taxonomies | 122300000X Dentist (Licence: MI 2901602009) |
| 122300000X Dentist (Licence: IL 019.033247) | |
| Enumeration Date | 2021-06-22 |
| Last Update Date | 2025-09-22 |