| NPI | 1033972302 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA DDS112414) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DN10000486) |
| Enumeration Date | 2024-01-31 |
| Last Update Date | 2025-12-10 |