| NPI | 1407388481 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 105847) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS041875) |
| Enumeration Date | 2017-03-30 |
| Last Update Date | 2024-03-05 |