| NPI | 1174517486 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 53053) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 53053) |
| 1223G0001X Dentist, General Practice (Licence: CT 009476) | |
| Enumeration Date | 2005-09-01 |
| Last Update Date | 2021-09-09 |