| NPI | 1144959701 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 111414) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NV 7809) |
| Enumeration Date | 2022-06-08 |
| Last Update Date | 2026-03-27 |