| NPI | 1366013047 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 107054) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL 26157) |
| 1223G0001X Dentist, General Practice (Licence: TX 37802) | |
| Enumeration Date | 2021-07-05 |
| Last Update Date | 2021-10-15 |