| NPI | 1588252951 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 108326) |
| Additional Taxonomies | 122300000X Dentist (Licence: WA DE61081225) |
| Enumeration Date | 2021-01-01 |
| Last Update Date | 2022-11-17 |