| NPI | 1710468376 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 51305) |
| Additional Taxonomies | 1223X0008X Dentist, Oral and Maxillofacial Radiology (Licence: CA 51305) |
| Enumeration Date | 2018-08-22 |
| Last Update Date | 2018-08-22 |