| NPI | 1609496637 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 106688) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 39018) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-04-20 |
| Last Update Date | 2024-09-14 |