| NPI | 1285086728 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: CA DDS104837) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: OR D11162) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-07-08 |
| Last Update Date | 2020-10-12 |