| NPI | 1619317666 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 102903) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NV S6-192C) |
| Enumeration Date | 2013-07-04 |
| Last Update Date | 2021-11-01 |