| NPI | 1487281507 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA CA106939)  | 
| Additional Taxonomies | 122300000X Dentist (Licence: WA DR61067033)  | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-03-26 | 
| Last Update Date | 2024-03-26 |