| NPI | 1801343124 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 100985) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OK 6878) |
| Enumeration Date | 2016-09-02 |
| Last Update Date | 2019-10-18 |