| NPI | 1811450943 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 107653) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS042581) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-04-06 |
| Last Update Date | 2023-01-22 |