| NPI | 1891472213 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA DDS111378) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DN1859867) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2023-06-28 |
| Last Update Date | 2025-07-24 |