| NPI | 1205157765 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 59343) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 59343) |
| 1223G0001X Dentist, General Practice (Licence: CA 59343) | |
| Enumeration Date | 2010-06-18 |
| Last Update Date | 2026-09-10 |