| NPI | 1306458583 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 105145) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA DDS105145) |
| Enumeration Date | 2020-08-19 |
| Last Update Date | 2026-03-02 |