| NPI | 1770129926 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 104212) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: CA 104212) |
| Enumeration Date | 2019-11-22 |
| Last Update Date | 2024-09-11 |