| NPI | 1184298226 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NV 7628TU) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 106138) |
| Enumeration Date | 2021-05-13 |
| Last Update Date | 2022-08-15 |