| NPI | 1710401914 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223D0004X Dentist Dentist Anesthesiologist (Licence: CA GA2160) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA DDS106892) |
| Enumeration Date | 2017-07-29 |
| Last Update Date | 2025-08-01 |