| NPI | 1477339067 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 109298) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MO 2024027688) |
| 1223G0001X Dentist, General Practice (Licence: KS 62233) | |
| Enumeration Date | 2023-09-07 |
| Last Update Date | 2024-10-13 |