| NPI | 1285887075 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D8090) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA DDS108389) |
| Enumeration Date | 2008-10-24 |
| Last Update Date | 2023-04-08 |