| NPI | 1659655090 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: CA 56422) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: WA DE60249811) |
| 1223P0300X Dentist, Periodontics (Licence: AZ D07398) | |
| Enumeration Date | 2011-10-04 |
| Last Update Date | 2024-03-06 |