| NPI | 1619289105 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 108080) |
| Additional Taxonomies | 122300000X Dentist (Licence: MO 2010016145) |
| 122300000X Dentist (Licence: CO 10515) | |
| 122300000X Dentist (Licence: OK 6218) | |
| Enumeration Date | 2010-07-13 |
| Last Update Date | 2023-04-21 |