| NPI | 1023605920 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: GA DN122937) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: CA DDS104948) |
| Enumeration Date | 2020-12-25 |
| Last Update Date | 2022-12-15 |