| NPI | 1407239288 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AZ D009238) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 107145) |
| Enumeration Date | 2015-06-30 |
| Last Update Date | 2025-02-11 |