| NPI | 1629635263 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA DDS105512) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA DDS105512) |
| Enumeration Date | 2019-05-20 |
| Last Update Date | 2024-03-29 |