| NPI | 1801317391 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ D009855) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 101502) |
| Enumeration Date | 2017-07-05 |
| Last Update Date | 2022-07-21 |