| NPI | 1710598271 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: CA DDS105397) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019032868) |
| Enumeration Date | 2020-08-10 |
| Last Update Date | 2023-08-21 |