| NPI | 1346990835 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 109883) |
| Additional Taxonomies | 122300000X Dentist (Licence: OR D11649) |
| 1223G0001X Dentist, General Practice (Licence: OR D11649) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2022-03-27 |
| Last Update Date | 2025-02-04 |