| NPI | 1275156499 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 106041) |
| Additional Taxonomies | 122300000X Dentist (Licence: CO .00000005) |
| Enumeration Date | 2020-05-21 |
| Last Update Date | 2022-04-12 |