| NPI | 1467947440 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 109141) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MN D14061) |
| Enumeration Date | 2018-06-22 |
| Last Update Date | 2025-01-16 |