| NPI | 1124594049 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 107988) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA DN1858152) |
| Enumeration Date | 2018-10-18 |
| Last Update Date | 2026-04-03 |