| NPI | 1376975375 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA DDS106220) |
| Additional Taxonomies | 122300000X Dentist (Licence: WA DE60402382) |
| Enumeration Date | 2013-08-01 |
| Last Update Date | 2021-10-26 |