| NPI | 1578922118 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 102303) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 1) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-02-10 |
| Last Update Date | 2019-03-27 |