| NPI | 1225695588 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA DDS107327) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DN1858382) |
| Enumeration Date | 2019-05-22 |
| Last Update Date | 2023-07-05 |