| NPI | 1356810683 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 101583) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 6491598) |
| Enumeration Date | 2018-11-15 |
| Last Update Date | 2024-01-09 |