| NPI | 1871373969 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CA 110418) |
| Additional Taxonomies | 122300000X Dentist (Licence: DC DEN2000274) |
| Enumeration Date | 2023-10-05 |
| Last Update Date | 2024-10-01 |