| NPI | 1477092633 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 105045) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CO 203510) |
| Enumeration Date | 2017-02-20 |
| Last Update Date | 2023-10-10 |