| NPI | 1588046049 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA DDS103682) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL 21707) |
| 122300000X Dentist (Licence: TX 30982) | |
| Enumeration Date | 2015-06-22 |
| Last Update Date | 2019-06-21 |