| NPI | 1396363362 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: AZ D10762) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA DDS106087) |
| Enumeration Date | 2020-07-07 |
| Last Update Date | 2021-06-18 |