| NPI | 1780420059 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA DDS111020) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MI 2901602297) |
| Enumeration Date | 2024-07-05 |
| Last Update Date | 2025-02-11 |