NPI | 1134485907 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: CA 64678) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2012-04-06 |
Last Update Date | 2021-06-10 |