| NPI | 1841770344 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CA 104352) |
| Additional Taxonomies | 122300000X Dentist (Licence: WI 1001917) |
| Enumeration Date | 2018-08-15 |
| Last Update Date | 2022-03-15 |