| NPI | 1679607790 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA CA55054) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 55054) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2022-01-13 |