| NPI | 1962173583 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA DDS106989) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DN1859278) |
| Enumeration Date | 2021-09-23 |
| Last Update Date | 2022-09-24 |