| NPI | 1710559976 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: CA DDS106081) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA DDS106081) |
| Enumeration Date | 2021-07-15 |
| Last Update Date | 2021-07-15 |