| NPI | 1588188098 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NV LL-549-21) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 101704) |
| Enumeration Date | 2017-07-27 |
| Last Update Date | 2021-12-06 |