| NPI | 1306216882 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 64979) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS042127) |
| 122300000X Dentist (Licence: CA 64979) | |
| Enumeration Date | 2015-09-28 |
| Last Update Date | 2020-09-15 |