| NPI | 1194243121 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 107874) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| Enumeration Date | 2017-08-30 |
| Last Update Date | 2022-10-07 |