| NPI | 1336757483 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: OR D12016) |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-07-15 |
| Last Update Date | 2024-08-22 |