| NPI | 1861983108 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA DDS103333) |
| Additional Taxonomies | 122300000X Dentist (Licence: AZ D010010) |
| Enumeration Date | 2018-05-22 |
| Last Update Date | 2019-06-07 |