| NPI | 1669736690 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA DDS59292) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: CA 59292) |
| Enumeration Date | 2012-06-25 |
| Last Update Date | 2019-06-11 |