| NPI | 1679180426 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: OR D11732) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: CA 105549) |
| Enumeration Date | 2020-09-25 |
| Last Update Date | 2024-05-06 |