| NPI | 1275751109 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: MT 26257) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: CA 44830) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2024-02-13 |