| NPI | 1073224176 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: PA DS044364) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 108417) |
| Enumeration Date | 2022-12-09 |
| Last Update Date | 2023-11-08 |