| NPI | 1346431590 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA N/A) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 058443) |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2016-08-09 |