| NPI | 1811502883 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0008X Dentist, Oral and Maxillofacial Radiology (Licence: FL DTP841) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA DDS105087) |
| Enumeration Date | 2020-09-15 |
| Last Update Date | 2025-01-28 |