| NPI | 1689192072 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA DDS45038) | 
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 45038) | 
| Enumeration Date | 2017-09-06 | 
| Last Update Date | 2023-03-25 |