| NPI | 1699446989 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: CA dds111641) |
| Additional Taxonomies | 122300000X Dentist (Licence: MI 2901602354) |
| Enumeration Date | 2021-09-25 |
| Last Update Date | 2025-09-25 |