| NPI | 1962942367 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist Endodontics (Licence: CA 101164) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 101164) |
| Enumeration Date | 2017-03-03 |
| Last Update Date | 2021-08-24 |