| NPI | 1134729262 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 110557) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0401417231) |
| Enumeration Date | 2020-10-28 |
| Last Update Date | 2025-09-04 |