| NPI | 1194367623 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 106021) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0401416723) |
| Enumeration Date | 2019-10-16 |
| Last Update Date | 2023-11-01 |