| NPI | 1659616654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: CA 57658) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: IN 12011365A) |
| Enumeration Date | 2012-12-01 |
| Last Update Date | 2018-01-24 |