| NPI | 1699469585 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA DDS112669) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN27975) |
| Enumeration Date | 2023-06-05 |
| Last Update Date | 2026-04-03 |