| NPI | 1417384751 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: CA 59544) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 59544) |
| Enumeration Date | 2013-10-01 |
| Last Update Date | 2023-10-06 |