| NPI | 1689467664 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WA DENT.DE.70092083) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 111530) |
| Enumeration Date | 2025-05-23 |
| Last Update Date | 2026-07-16 |