| NPI | 1043695299 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA DDS108252)  | 
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WA DE60584840)  | 
| Enumeration Date | 2015-07-29 | 
| Last Update Date | 2023-01-27 |