| NPI | 1255004933 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 108919) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN25540) |
| Enumeration Date | 2021-07-28 |
| Last Update Date | 2023-07-11 |