| NPI | 1326549445 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA DDS101628) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN22148) |
| Enumeration Date | 2018-02-23 |
| Last Update Date | 2022-01-04 |