| NPI | 1043791718 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 107280) |
| Additional Taxonomies | 122300000X Dentist (Licence: MO 2018023890) |
| Enumeration Date | 2018-08-22 |
| Last Update Date | 2022-08-22 |