| NPI | 1164984340 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA DDS108256) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: MA DN1859052) |
| Enumeration Date | 2019-04-05 |
| Last Update Date | 2023-06-13 |