| NPI | 1669909289 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: CA DDS101125) |
| Additional Taxonomies | 1223X2210X Dentist, Orofacial Pain (Licence: CA 101125) |
| Enumeration Date | 2017-05-12 |
| Last Update Date | 2026-04-08 |