| NPI | 1073174884 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 104881) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 35258) |
| Enumeration Date | 2019-06-23 |
| Last Update Date | 2022-06-02 |