| NPI | 1598220790 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 29852) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 108452) |
| Enumeration Date | 2019-02-01 |
| Last Update Date | 2019-11-21 |