| NPI | 1275930224 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NV 6552) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA DDS104821) |
| Enumeration Date | 2014-11-19 |
| Last Update Date | 2021-05-11 |