| NPI | 1073997409 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 105715) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 058541-1) |
| Enumeration Date | 2015-07-15 |
| Last Update Date | 2023-01-16 |