| NPI | 1063137305 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 108094) |
| Additional Taxonomies | 122300000X Dentist (Licence: MO 2022034664) |
| Enumeration Date | 2022-10-10 |
| Last Update Date | 2024-09-15 |