| NPI | 1578233557 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223X0008X Dentist, Oral and Maxillofacial Radiology (Licence: CA 106967) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 106967) |
| Enumeration Date | 2021-09-20 |
| Last Update Date | 2025-02-12 |