| NPI | 1740693738 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: CA 105755) |
| Additional Taxonomies | 122300000X Dentist (Licence: IN 12012670A) |
| Enumeration Date | 2014-06-06 |
| Last Update Date | 2022-12-20 |