| NPI | 1174106447 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA DDS108695) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: AZ D011146) |
| Enumeration Date | 2021-05-04 |
| Last Update Date | 2023-08-30 |