| NPI | 1518568138 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: CA DDS105763) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 105763) |
| Enumeration Date | 2020-11-02 |
| Last Update Date | 2024-01-03 |