| NPI | 1992327456 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 107926) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA E20969) |
| Enumeration Date | 2020-05-07 |
| Last Update Date | 2025-07-17 |