| NPI | 1508395484 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA DDS103120) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS041270) |
| Enumeration Date | 2017-06-05 |
| Last Update Date | 2021-11-22 |