| NPI | 1801215967 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 101126) |
| Additional Taxonomies | 122300000X Dentist (Licence: NV 7922) |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2026-01-05 |