| NPI | 1659826147 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 109494) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 32342) |
| Enumeration Date | 2016-08-24 |
| Last Update Date | 2024-02-17 |