| NPI | 1417089038 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: CA 55372) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: CA 55372) |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2012-07-24 |