| NPI | 1588022636 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NV S6-218C) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 65346) |
| Enumeration Date | 2016-02-03 |
| Last Update Date | 2024-04-04 |