| NPI | 1033562939 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 104759) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WA 00000000) |
| 1223G0001X Dentist, General Practice (Licence: OR D10635) | |
| Enumeration Date | 2016-07-15 |
| Last Update Date | 2020-11-24 |