| NPI | 1730852229 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NV 7835) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 106723) |
| Enumeration Date | 2021-07-29 |
| Last Update Date | 2023-07-04 |