| NPI | 1720644891 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: CA 103674) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 103674) |
| Enumeration Date | 2019-05-14 |
| Last Update Date | 2023-11-30 |