| NPI | 1477962538 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA DDS64245) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS040147) |
| Enumeration Date | 2014-08-03 |
| Last Update Date | 2023-08-14 |