| NPI | 1578791430 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA DDS105833) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DN1857519) |
| Enumeration Date | 2009-06-30 |
| Last Update Date | 2023-01-24 |