| NPI | 1073854931 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 111277) |
| Additional Taxonomies | 122300000X Dentist (Licence: UT 8696751-9921) |
| Enumeration Date | 2013-03-01 |
| Last Update Date | 2025-02-26 |