| NPI | 1063040913 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 106038) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NV s6-243C) |
| Enumeration Date | 2020-03-27 |
| Last Update Date | 2026-04-23 |