| NPI | 1376104695 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 104197) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA PENDING) |
| 1223G0001X Dentist, General Practice (Licence: CA PENDING) | |
| 1223G0001X Dentist, General Practice (Licence: CA 104197) | |
| Enumeration Date | 2019-06-26 |
| Last Update Date | 2021-11-03 |