| NPI | 1285867721 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 60120) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: MA 10625) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 60120) | |
| Enumeration Date | 2009-09-01 |
| Last Update Date | 2022-06-14 |