| NPI | 1043277551 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA SP256) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: FL DTP 415) |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2023-03-07 |