| NPI | 1295219202 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OR D11185) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA DDS103066) |
| Enumeration Date | 2018-09-17 |
| Last Update Date | 2020-02-13 |