| NPI | 1699449116 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CA 111115) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: TX 37495) |
| Enumeration Date | 2021-08-07 |
| Last Update Date | 2025-01-27 |