| NPI | 1467005819 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0008X Dentist, Oral and Maxillofacial Radiology (Licence: CA DDS103898) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA DDS103898) |
| Enumeration Date | 2019-07-24 |
| Last Update Date | 2024-06-10 |