| NPI | 1467086033 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 108139) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: MA DN1858705) |
| Enumeration Date | 2020-02-23 |
| Last Update Date | 2024-07-04 |