| NPI | 1801262621 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OR 10839) |
| Additional Taxonomies | 122300000X Dentist (Licence: AZ D011611) |
| 122300000X Dentist (Licence: CA 64766) | |
| Enumeration Date | 2015-08-16 |
| Last Update Date | 2026-05-26 |