| NPI | 1548708498 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CA 104749) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL 22763) |
| Enumeration Date | 2017-02-10 |
| Last Update Date | 2024-01-09 |