| NPI | 1609451855 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 108587) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 39095) |
| Enumeration Date | 2021-03-09 |
| Last Update Date | 2023-06-02 |