| NPI | 1861708778 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 59679) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CO 203315) |
| Enumeration Date | 2010-08-30 |
| Last Update Date | 2025-11-02 |