| NPI | 1508355579 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: CA 104148) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 104148) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0401417497) | |
| Enumeration Date | 2018-05-05 |
| Last Update Date | 2023-07-10 |