| NPI | 1619421815 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 100650) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA DDS100650) |
| Enumeration Date | 2016-08-05 |
| Last Update Date | 2022-08-30 |