| NPI | 1114598646 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 108909) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NV S6-229C) |
| Enumeration Date | 2021-07-06 |
| Last Update Date | 2024-10-08 |