| NPI | 1275933970 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 109728) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 64022) |
| 122300000X Dentist (Licence: WA 60499001) | |
| Enumeration Date | 2014-08-29 |
| Last Update Date | 2024-08-01 |