| NPI | 1376676353 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CO DEN.00202661) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 54145) |
| 122300000X Dentist (Licence: NC 9199) | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: WA DR60353632) | |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2017-04-04 |