| NPI | 1629742580 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 110853) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019.033314) |
| Enumeration Date | 2021-08-04 |
| Last Update Date | 2024-10-04 |