| NPI | 1982058194 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: CA DDS105533) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: NY 000068) |
| 1223P0300X Dentist, Periodontics (Licence: VA 0401415593) | |
| Enumeration Date | 2016-04-14 |
| Last Update Date | 2022-03-17 |