| NPI | 1326534090 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: SC DGD.10161) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 102718) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: OR 11285) | |
| Enumeration Date | 2018-07-06 |
| Last Update Date | 2022-05-05 |