| NPI | 1093356016 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X (Licence: CA 104403) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 104403) |
| 1223X2210X Dentist, Orofacial Pain (Licence: CA DDS104403) | |
| Enumeration Date | 2019-10-01 |
| Last Update Date | 2022-06-13 |