| NPI | 1164984571 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 12489) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 103539) |
| Enumeration Date | 2019-04-03 |
| Last Update Date | 2022-12-07 |