| NPI | 1124246376 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: CA 51668) |
| Additional Taxonomies | 122300000X Dentist (Licence: WA DE00009723) |
| 1223P0221X Dentist Pediatric Dentistry (Licence: TN 10407) | |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2024-05-24 |