| NPI | 1578176319 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 105402) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 105204) |
| Enumeration Date | 2020-08-30 |
| Last Update Date | 2020-09-02 |