| NPI | 1578917803 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AZ D009617) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA DDS100716) |
| Enumeration Date | 2016-04-23 |
| Last Update Date | 2025-09-23 |