| NPI | 1861014672 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA DDS106103) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OH RES.004191) |
| Enumeration Date | 2020-05-14 |
| Last Update Date | 2021-09-16 |