| NPI | 1548600844 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA dds103737) |
| Additional Taxonomies | 122300000X Dentist (Licence: WA DE60390138) |
| Enumeration Date | 2013-07-01 |
| Last Update Date | 2021-05-03 |