| NPI | 1669097523 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA DDS107356) |
| Additional Taxonomies | 122300000X Dentist (Licence: OH RES.004241) |
| 122300000X Dentist (Licence: IL 019.033000) | |
| Enumeration Date | 2020-06-16 |
| Last Update Date | 2023-10-03 |