| NPI | 1396358214 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 105376) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL 159725) |
| Enumeration Date | 2020-08-29 |
| Last Update Date | 2020-08-29 |