| NPI | 1750962262 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: WA DENT.DE.61604081) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 110559) |
| 122300000X Dentist (Licence: WA DE6160481) | |
| Enumeration Date | 2021-04-16 |
| Last Update Date | 2025-10-03 |