| NPI | 1720825540 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 13970) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA DDS111349) |
| Enumeration Date | 2024-07-10 |
| Last Update Date | 2025-04-25 |