| NPI | 1053920934 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA DDS105858) |
| Additional Taxonomies | 1223D0001X Dentist, Dental Public Health (Licence: CA DDS105858) |
| Enumeration Date | 2020-07-28 |
| Last Update Date | 2025-10-20 |