| NPI | 1528366143 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 63446) |
| Additional Taxonomies | 1223D0001X Dentist, Dental Public Health (Licence: CA 63446) |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TX 26311) | |
| Enumeration Date | 2011-03-06 |
| Last Update Date | 2022-05-17 |