| NPI | 1417126913 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 55345) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019.027082) |
| Enumeration Date | 2008-02-28 |
| Last Update Date | 2023-03-10 |