| NPI | 1689014490 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 105977) |
| Additional Taxonomies | 122300000X Dentist (Licence: OR D10800) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-06-26 |
| Last Update Date | 2023-05-05 |