| NPI | 1679109987 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 111035) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MD 17174) |
| Enumeration Date | 2020-03-18 |
| Last Update Date | 2025-03-25 |