| NPI | 1982057709 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AZ D011046) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 100451) |
| Enumeration Date | 2016-07-16 |
| Last Update Date | 2022-11-30 |