| NPI | 1770174195 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: CA DDS111300) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA DN1859461) |
| Enumeration Date | 2021-01-28 |
| Last Update Date | 2025-07-21 |