| NPI | 1972127538 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: CA DDS107251) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: NV S4-139C) |
| Enumeration Date | 2020-05-29 |
| Last Update Date | 2025-11-25 |