| NPI | 1598230161 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA 205107) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA DDSS103294) |
| Enumeration Date | 2018-10-09 |
| Last Update Date | 2026-01-23 |