| NPI | 1487099636 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CA 104407) |
| Additional Taxonomies | 122300000X Dentist (Licence: TN 12652) |
| 1223G0001X Dentist General Practice (Licence: VA 0401415125) | |
| Enumeration Date | 2013-05-01 |
| Last Update Date | 2025-05-07 |