| NPI | 1104225994 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: CA DDS108191) |
| Additional Taxonomies | 122300000X Dentist (Licence: WI 1000988-15) |
| 122300000X Dentist (Licence: FL DN27647) | |
| Enumeration Date | 2014-08-18 |
| Last Update Date | 2023-05-07 |