| NPI | 1497329304 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 108614) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WI 101191-875) |
| 1223G0001X Dentist, General Practice (Licence: MO 2023039872) | |
| Enumeration Date | 2021-05-14 |
| Last Update Date | 2023-10-12 |