| NPI | 1295802288 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 62290) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA 21643) |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2017-01-13 |