| NPI | 1760721104 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: CA 104873) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: HI DT-2594) |
| 1223P0300X Dentist, Periodontics (Licence: OH 30024054) | |
| Enumeration Date | 2013-02-05 |
| Last Update Date | 2023-10-02 |