| NPI | 1801456306 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 13594) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA DDS104902) |
| Enumeration Date | 2019-06-17 |
| Last Update Date | 2023-08-31 |