| NPI | 1538360797 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 58467) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: CA 58467) |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2026-07-13 |