| NPI | 1427771104 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: CA DDS108595) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NV 7725) |
| Enumeration Date | 2022-09-19 |
| Last Update Date | 2023-03-31 |