| NPI | 1164807384 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MD LL939) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 64319) |
| Enumeration Date | 2015-07-29 |
| Last Update Date | 2025-06-17 |