| NPI | 1780254391 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 109980) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 37312) |
| Enumeration Date | 2021-06-26 |
| Last Update Date | 2025-02-20 |