| NPI | 1962890608 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 65026) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 057989) |
| Enumeration Date | 2015-01-05 |
| Last Update Date | 2023-02-21 |