| NPI | 1881383891 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA DDS110127) |
| Additional Taxonomies | 122300000X Dentist (Licence: MO 2023023286) |
| 1223D0001X Dentist, Dental Public Health (Licence: MO 2023023286) | |
| 1223G0001X Dentist, General Practice (Licence: MO 2023023286) | |
| Enumeration Date | 2023-05-04 |
| Last Update Date | 2024-06-24 |