| NPI | 1710544770 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CO 00204545) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 105022) |
| Enumeration Date | 2019-05-24 |
| Last Update Date | 2023-01-25 |