| NPI | 1417643826 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 110688) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL 28200) |
| Enumeration Date | 2023-04-18 |
| Last Update Date | 2024-11-25 |