| NPI | 1306568530 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 112685) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0401418677) |
| 122300000X Dentist (Licence: FL DN27439) | |
| Enumeration Date | 2022-09-14 |
| Last Update Date | 2026-03-17 |