| NPI | 1386802627 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 57094) |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2008-05-22 |
| Last Update Date | 2022-01-05 |