| NPI | 1952612988 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 107104) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: CA 107104) |
| 1223G0001X Dentist, General Practice (Licence: ID D-4305) | |
| 1223G0001X Dentist, General Practice (Licence: TX 35033) | |
| Enumeration Date | 2010-06-24 |
| Last Update Date | 2022-03-15 |