| NPI | 1609449826 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: GA DN122401) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 106448) |
| Enumeration Date | 2021-07-24 |
| Last Update Date | 2021-08-13 |