| NPI | 1922772987 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 111322) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WI 1002668-15) |
| Enumeration Date | 2021-08-04 |
| Last Update Date | 2026-02-23 |