| NPI | 1346375904 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: MO 2003011674) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: IA 09926) |
| 1223P0221X Dentist Pediatric Dentistry (Licence: WI 23366-875) | |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2022-11-15 |