| NPI | 1053710699 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 100245) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA DDS100245) |
| 122300000X Dentist (Licence: OH 30-024310) | |
| Enumeration Date | 2014-08-20 |
| Last Update Date | 2024-06-21 |