| NPI | 1538501895 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 64005) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS039676) |
| Enumeration Date | 2013-07-26 |
| Last Update Date | 2018-03-17 |