| NPI | 1124900550 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA 1598748410) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 8860) |
| Enumeration Date | 2025-07-25 |
| Last Update Date | 2025-07-25 |