| NPI | 1972023307 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 110293) |
| Additional Taxonomies | 122300000X Dentist (Licence: AZ D009790) |
| Enumeration Date | 2017-06-27 |
| Last Update Date | 2024-10-30 |