NPI | 1558499863 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 49407) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 49407) |
Enumeration Date | 2007-02-28 |
Last Update Date | 2020-04-09 |